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How to Seal Clear Cornea Incision After Cataract Surgery: The Role of a Liquid Ocular Bandage Matteo Piovella, MD & Barbara Kusa, MD Centro di Microchirurgia Ambulatoriale Monza Italy Dr Piovella has the following Financial interests or relationships to disclose as consultant: Abbott Medical Optics INC BD Medical Ophthalmic Systems Slack INC [email protected] How To Prepare OcuSeal ™ OcuSeal ™ is a synthetic hydrogel (85% water) packaged as two components: powder and liquid separately Hydrogel = cross-linked chemical with attached water molecules. Solution must be used within 30 seconds! [email protected] How To Prepare OcuSeal ™ BD Ophthalmic System [email protected] OcuSeal ™ Histologic Study Conclusions • • • • Biocompatible Re-epithelialisation: evident Neovascularization: not evident Degradation of OcuSeal™: evident [email protected] OcuSeal ™ Chemistry • 2 active components: – PEG (ester) & PEI (water soluble amine) • PEG + PEI Cross-linked hydrogel (~30 secs) • Hydrogel film is spread over patient’s wound • Interacts with underlying tissues • Forms a seal lasting 2-3 days. – Tissue compliant – Tissue adherent – Elastic (gelatinous) [email protected] Degradation of OcuSeal ™ • Hydrogel: applied on the external surface of the eye, it naturally sloughs off. • OcuSeal ™ within the wound: naturally degraded by hydrolysis. • Tissue healing occurs at roughly the same rate of hydrogel degradation, hence the space is taken up by regenerated tissue. • Degradation by-products are water soluble, and therefore are reabsorbed and excreted through the kidneys. [email protected] OcuSeal™ Clinical Results 79 Eyes Methods: • At the end of cataract surgery, 79 cataract surgery patients received OcuSeal ™ liquid bandage for corneal incision sealing ( BD Medical Ophthalmic Systems) . • 79 patients: 45 males – 34 females • Mean age: 66.83 ± 11.32 yrs. • Upon application, OcuSeal ™ liquid bandage cross-links within 30 seconds and forms a smooth, soft and transparent protective barrier film over corneal incisions. Results: • No patient discomfort , complications or adverse events were noted during the first three months after application. • During the learning curve, OcuSeal ™ was not applied correctly in 16 eyes. • This was due to the fact that the product polymerises in 30 seconds and application onto the cornea was not quick enough . • The liquid bandage surplus disappears (slit lamp evaluation) in all patients within 12 hours. [email protected] Standard Clear Cornea Incision Vs OcuSeal ™ Use at Day 1 po No OcuSeal OcuSeal [email protected] 24 Hours After Surgery Patient Foreign Body Feeling OcuSeal™ Use VS OcuSeal™ Unused BCVA - 79 EYES OcuSeal™ Use 79 Eyes Without OcuSeal™ 72 Eyes [email protected] Patient Comfort (Foreign Body Feeling) Vs Tissue Adherent Time Waiting Time Before Speculum Removal (31 Eyes) 30 Secs (29 Eyes) 45 Secs [email protected] Why OcuSeal ™? • • • • • • • • • Ease to use May prevent bacterial inflow Provides barrier to microbial infection Long lasting action Enough for the incision to heal Degrades as tissue is regenerated Promotes natural healing Transparent Comfortable for the patient [email protected] OcuSeal ™ Application SurplusOcuSeal ™ Application Surplus Vs Recovery Time for Smoothly Cornea Surfice – 11 Eyes 100% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Within 12 hrs [email protected] Thank you for your attention !
